All posts in Clinical Case of the Week

Hello, Nick Rinard PT community!

Katie here…I’m so excited to share good news!

I discharged a patient today after just 5 visits who had been suffering with chronic shoulder pain for several years.

It is such a pleasure to help my patients get results! Are you living with chronic pain? Maybe you don’t have to!

Give us a call! 503-244-6232

-Katie Noles-Bowers, DPT


Gardners, are you ready?


It may not seem like it on some days, but spring is coming! 

Every year, we see many gardeners who are unable to get out in their flower and veggie beds because of back, neck, arm, and, thumb, or knee pain. 

Here are some helpful hints to help keep you in your garden on the rare nice days that we have:

-Avoid bending for extended periods. 

-Get a kneeling pad out and use it! 

-Some people do very well with a stool also.

-Keep the things you need close at hand.  This reduces the amount of reaching and twisting that you need to do!

-Keep your back straight while mowing the yard and using equipment.

Still having pain that’s keeping you and your green thumb inside?

Nick Rinard Physical Therapy is here to help.

Call 503-244-6232 today!


Mark Laslett and the MDT method at Nick Rinard Physical Therapy

Clinical appearance of persistent sternoclavicular joint pain

This is a simple case of persistent pain felt in the right sternoclavicular joint and clavicle region with somatic referred pain into the right trtrapezius and scapular region. These may be missed if the trapezius and scapular pain are dominant. The standard active, passive and isometric resisted shoulder tests are sufficient to identify the problem, but some additional tests that target the clavicular joints, plus tenderness on the STC Joint line helps to confirm the clinical diagnosis. The special orthopaedic tests for rotator cuff lesions are unnecessary and usually confuse the picture. In most cases the STC joint is visibly swollen. The treatment of choice is intra-articular corticosteroid injection. This rarely fails to rapidly abolish the pain, and only occasionally is a second injection required. Movement therapies are routinely unsuccessful, often aggravating the pain.

Posted by Dr Mark Laslett on Monday, September 17, 2018


MDT method is the recipe for knee pain

GPs have rubbished popular and "fad" treatments for osteoarthritis (OA), including opioids, acupuncture, glucosamine,…

Posted by McKenzie Institute USA on Monday, September 10, 2018


Nick Rinard Physical Therapy uses MDT to treat patients appropriately “Overdiagnosis can harm patients by leading to overtreatment, diagnosis related anxiety or…

Posted by McKenzie Institute International on Saturday, August 25, 2018


Mck on Osteroarthritis and MRI interpetations “… estimates of MRI osteoarthritis prevalence among…

Posted by McKenzie Institute International on Monday, August 20, 2018


Mck and Nick Rinard PT observes patterns “Conclusions: Observed patterns of cervical radiculopathy only followed the standard pattern in…

Posted by McKenzie Institute International on Saturday, August 18, 2018


Nick Rinard Physical Therapy uses McK Mechanical investigations

'Directional preference of the extremity: a preliminary investigation'. Well done to the folks from Maccio Physical…

Posted by McKenzie Institute USA on Monday, August 13, 2018


Treating Low Back Pain with Physical Therapy First


Low back pain is one of the most common causes of disability in the world. A recent study found that “Out of 291 conditions studied in the Global Burden of Disease 2010 Study, LBP ranked highest in terms of disability (YLDs), and sixth in terms of overall burden.” With a large range of different types of back pain it can be extremely frustrating finding relief from this type of pain.

Luckily there has been a large effort to find the best approach to dealing with low back pain. A 2018 study comparing healthcare costs for patients with a diagnosis of low back pain between the ages of 18 and 64. Interventions studied included differences in opioid prescription, health care utilization, and timing of PT intervention. This study found that patients who saw a PT at first had a lower utilization of high‐cost medical services (MRI, surgical intervention, emergency room visits) as well as lower opioid use.

Another study looked at the differences in long term outcomes in patients with spinal stenosis given PT or surgery. The results of this study after 2 years found that patients “did not differ significantly between patients who had undergone surgery and those who avoided surgery.” This shows that physical therapy alone is a much safer, cheaper, and equally effective choice.

Understanding your back pain and using your own body to fix itself has proven to be the least expensive and best outcome tool when dealing with low back pain. Therefore be your own advocate when dealing with new or recurring back pain and try PT first!


Frogner, B. K., Harwood, K., Andrilla, C. H. A., Schwartz, M., & Pines, J. M. (2018). Physical Therapy as the First Point of Care to Treat Low Back Pain: An Instrumental Variables Approach to Estimate Impact on Opioid Prescription, Health Care Utilization, and Costs. Health services research.

Hoy, D., March, L., Brooks, P., Blyth, F., Woolf, A., Bain, C., & Murray, C. (2014). The global burden of low back pain: estimates from the Global Burden of Disease 2010 study. Annals of the rheumatic diseases73(6), 968-974.

Minetama, M., Kawakami, M., Nakagawa, M., Ishimoto, Y., Nagata, K., Fukui, D., & Sakon, N. (2018). A comparative study of 2-year follow-up outcomes in lumbar spinal stenosis patients treated with physical therapy alone and those with surgical intervention after less successful physical therapy. Journal of Orthopedic Science23(3), 470-476.